How to fight the fear of breast cancer recurrence

For many of the 3.8 million women in the U.S. who have survived breast cancer, there’s overwhelming fear the disease will come back.

Now, researchers are working to determine the best way to help survivors face those fears.

There’s always something happening in the Lyons family backyard. Kristen Lyons fought hard for her family to get to this point. She was diagnosed with breast cancer at age 39.

“I was thinking about my kids and, ‘Oh my goodness, what does this mean for our future?’” Lyons said.

Lyons had treatment and beat the cancer. She rang the clinic bell, signaling the all-clear. But that started an internal battle that got worse.

“I thought I should have a new lease on life because here we are cancer-free, you know, and instead I found myself getting more and more worried and anxious,” recalled Lyons.

“The No. 1 problem that almost every cancer survivor that I work with has dealt with is the fear that it’s going to come back,” explained Shelley Johns, a clinical health psychologist at Regenstrief Institute in Indianapolis.

Johns and her colleagues conducted a clinical trial comparing three interventions for people struggling with fear of cancer recurrence. The researchers found one method produced significant reduction. It’s called acceptance and commitment therapy, or ACT.

“We’re all going to have thoughts and feelings that are uncomfortable. They just kind of naturally come into our mind. So, it’s about accepting those thoughts and feelings without necessarily getting hooked by them,” Johns said.

Johns and her team met with survivors for six weeks and used mindfulness practices, like meditation, to help them focus. Then patients developed a personal plan to give priority to their values, activities, and people important to them. Kristen calls ACT life-changing.

“I go down the worry path, but I now have the tools to reign it back in, and that’s made all the difference,” Lyons said.

Acceptance and commitment therapy has been around for two decades, but Johns said it has never been used to help people struggling with fear of cancer recurrence until now. Researchers tested the interventions in a sample of 90 breast cancer survivors. Johns says she would like to conduct a similar trial involving a much larger number of survivors.


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